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Individual

MARSHA MCCORMAC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1615 BERKSHIRE, SUITE 208, BROKEN ARROW, OK 74012
(918) 855-8639
Mailing address
105 N 68TH ST, BROKEN ARROW, OK 74014-6952
(918) 855-8639

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
174
OK

Other

Enumeration date
10/29/2014
Last updated
10/29/2014
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